Folic acid and bread

In the news - FSA recommend that folic acid to be added to bread to help reduce the incidence of foetal neural tube defects.

During the past week the Food Standards Agency (FSA) have made specific recommendations to UK health ministers relating to the need for compulsory fortification of a widely consumed food, such as bread, with folic acid. The FSA have made this somewhat controversial, although arguably necessary, recommendation as part of a strategy that is set to reduce the incidence of foetal neural tube defects such as spina bifida.

Folic acid is a synthetic form of folate, a water soluble B-vitamin that plays an essential role in maintaining and producing new cells. It plays an especially important role during the early stages of pregnancy when rapid cell development is occurring. As folate/folic acid is a water soluble vitamin it isn't stored by the body, this is why the government recommends that those trying for, or expecting a baby should supplement their diet with 400mg folic acid a day up until the 12th week of pregnancy.

It is thought that fewer than 50% of women adhere to this advice and, as up to half of pregnancies are unplanned, many miss this window of opportunity. Although folate occurs naturally in many of the foods we eat, especially in leafy green vegetables, beans and peas, the body is not able to absorb a sufficient amount of folate from these foods as is needed during the early stages of pregnancy, which is why supplementation is recommended.

Concerns are high as insufficient maternal consumption of folic acid in the initial stages of pregnancy can lead to neural tube detects whereby the foetus's spine is unable to develop properly, resulting in paralysis, hydrocephalus, sight problems and stalled development.

It is estimated that between 700 - 900 babies a year are born with neural tube defects such as spina bifida and compulsory fortification of folic acid is thought to be a practical way to reduce this figure. Mandatory fortification of flour has already been introduced in America, Canada and Chile and defect rates have been halved with little apparent disadvantages.

Fortification has not yet been introduced in the UK as many oppose this 'compulsory' addition to the food we eat and concerns have been raised about possible side effects. However, the FSA believe that the benefits of this addition will far outweigh the costs.

Although initial plans proposed the fortification of all types of white and brown bread, the FSA are currently deliberating as to whether flour instead of just bread should be fortified so that an even wider percentage of the population are reached. UK ministers will decide over the coming months as to how best to implement this proposal and how to control the levels of folic acid in other fortified foods such as margarines and breakfast cereals.

Despite the details of the proposal not yet being finalised, the message is clear; all women trying for a baby should be supplementing their diet with folic acid to help protect the health of their baby when they conceive. So, until new measures of fortification are introduced its best to adhere to current recommendations and take a daily supplement of 400mg of folic acid just to be on the safe side.

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